Prescription drug abuse

Overview

Prescription drug abuse is the use of a prescription medicine in a way not intended by the prescriber. Prescription drug abuse, also called prescription drug misuse, includes everything from taking a friend's prescription painkiller for your backache to snorting or injecting ground-up pills to get high. Prescription drug abuse may become ongoing and compulsive, despite the negative consequences.

An increasing problem, prescription drug abuse can affect all age groups, including teens. The prescription drugs most often misused include opioid painkillers, anti-anxiety medicines, sedatives and stimulants.

Early identification of prescription drug abuse and early intervention may prevent the problem from turning into an addiction.

Symptoms

Signs and symptoms of prescription drug abuse depend on the specific drug. Because of their mind-altering properties, the most misused prescription drugs are:

• Opioids used to treat pain, such as medicines containing oxycodone (Oxycontin, Percocet) and those containing hydrocodone (Norco)
• Anti-anxiety medicines, sedatives and hypnotics used to treat anxiety and sleep disorders, such as alprazolam (Xanax), diazepam (Valium) and zolpidem (Ambien)
• Stimulants used to treat attention-deficit/hyperactivity disorder (ADHD) and certain sleep disorders, such as methylphenidate (Ritalin, Concerta, others), dextroamphetamine-amphetamine (Adderall XR, Mydayis) and dextroamphetamine (Dexedrine)

Signs and symptoms of prescription drug abuse

Opioids

• Constipation
• Nausea
• Feeling high
• Slowed breathing rate
• Drowsiness
• Confusion
• Poor coordination
• Increased dose needed for pain relief
• Worsening or increased sensitivity to pain with higher doses

Anti-anxiety medicines and sedatives

• Drowsiness
• Confusion
• Unsteady walking
• Slurred speech
• Poor concentration
• Dizziness
• Problems with memory
• Slowed breathing

Stimulants

• Increased alertness
• Feeling high
• Irregular heartbeat
• High blood pressure
• High body temperature
• Reduced appetite
• Insomnia
• Agitation
• Anxiety
• Paranoia

Other signs

• Forging, stealing or selling prescriptions
• Taking higher doses than prescribed
• Being hostile or having mood swings
• Sleeping less or more
• Making poor decisions
• Being unusually energetic, high or revved up
• Being drowsy
• Requesting early refills or continually "losing" prescriptions, so more prescriptions must be written
• Trying to get prescriptions from more than one prescriber

When to see a doctor

Talk with your health care provider if you think you may have a problem with prescription drug use. You may feel embarrassed to talk about it — but remember that medical professionals are trained to help you, not judge you. It's easier to face the problem early before it becomes an addiction and leads to more-serious problems.

Causes

Teens and adults abuse prescription drugs for many reasons, such as:

• To feel good or get high
• To relax or relieve tension
• To ease pain
• To reduce appetite
• To increase alertness
• To experiment with mental effects of the substance
• To maintain an addiction and prevent withdrawal
• To be accepted by peers or to be social
• To try to improve concentration and school or work performance

Risk factors

Some people fear that they may become addicted to medicines prescribed for medical conditions, such as painkillers prescribed after surgery. But you can reduce your risk by carefully following your health care provider's instructions on how to take your medicine.

Prescription drug abuse is highest among teens and young adults.

Risk factors for prescription drug misuse include:

• Past or present addictions to other substances, including alcohol and tobacco
• Family history of substance abuse problems
• Certain preexisting mental health conditions
• Peer pressure or a social environment where there's drug use
• Easier access to prescription drugs, such as having prescription medicines in the home medicine cabinet
• Lack of knowledge about prescription drugs and their potential harm

Older adults and prescription drug abuse

Prescription drug abuse in older adults is a growing problem, especially when they combine drugs with alcohol. Having multiple health problems and taking multiple drugs can put people at risk of misusing drugs or becoming addicted.

Complications

Abusing prescription drugs can cause a number of problems. Prescription drugs can be especially dangerous — and even lead to death — when taken in high doses, when combined with other prescription drugs or certain over-the-counter medicines, or when taken with alcohol or illegal or recreational drugs.

Medical consequences

Here are examples of serious consequences of prescription drug abuse:

• Opioids can cause a slowed breathing rate and potential for breathing to stop. Opioids can also cause coma. An overdose can lead to death.
• Anti-anxiety medicines and sedatives — medicines to help you feel calm or less anxious — can cause memory problems, low blood pressure and slowed breathing. An overdose can cause coma or death. Abruptly stopping the medicine may cause withdrawal symptoms that can include an overactive nervous system and seizures.
• Stimulants can cause an increase in body temperature, heart problems, high blood pressure, seizures or tremors, hallucinations, aggressiveness, and paranoia.

Physical dependence and addiction

Because commonly abused prescription drugs activate the brain's reward center, it's possible to develop physical dependence and addiction.

• Physical dependence. Physical dependence, also called drug tolerance, is the body's response to long-term use of a drug. People who are physically dependent on a drug may need higher doses to get the same effects and may experience withdrawal symptoms when cutting back or abruptly stopping the drug.
• Addiction. People who are addicted to a drug can have physical dependence, but they also compulsively seek a drug and continue to use it even when that drug causes major problems in their lives.

Other consequences

Other potential consequences include:

• Engaging in risky behaviors because of poor judgment
• Using illegal or recreational drugs
• Being involved in crime
• Being involved in motor vehicle accidents
• Showing decreased school or work performance
• Having troubled relationships

Prevention

Prescription drug abuse may occur in people who need painkillers, sedatives or stimulants to treat a medical condition. If you're taking a prescription drug that commonly leads to drug misuse, here are ways to reduce your risk:

• Make sure you're getting the right medicine. Make sure your health care provider clearly understands your condition and the signs and symptoms. Tell your health care provider about all your prescriptions, as well as over-the-counter medicines, herbs and supplements, and alcohol and other drug use. Ask your doctor whether there's another medicine with ingredients that have less potential for addiction.
• Check in with your health care provider. Talk with your health care provider on a regular basis to make sure that the medicine is working and you're taking the right dose.
• Follow directions carefully. Use your medicine the way it was prescribed. Don't stop or change the dose of a drug on your own if it doesn't seem to be working without talking to your health care provider. For example, if you're taking a pain medicine that isn't adequately controlling your pain, don't take more.
• Know what your medicine does. Ask your health care provider or pharmacist about the effects of your medicine, so you know what to expect. Also check if other drugs, over-the-counter products or alcohol should be avoided when taking this medicine.
• Never use another person's prescription. Everyone is different. Even if you have a similar medical condition, it may not be the right medicine or dose for you.
• Don't order prescriptions online unless they're from a trustworthy pharmacy. Some websites sell counterfeit prescription and over-the-counter drugs that could be dangerous.

Preventing prescription drug abuse in teens

Prescription drugs are commonly misused substances by young people. Follow these steps to help prevent your teen from abusing prescription medicines.

• Discuss the dangers. Emphasize to your teen that just because drugs are prescribed by a health care provider doesn't make them safe — especially if they were prescribed to someone else or if your child is already taking other prescription medicines.
• Set rules. Let your teen know that it's not OK to share medicines with others — or to take drugs prescribed for others. Emphasize the importance of taking the prescribed dose and talking with the health care provider before making changes.
• Discuss the dangers of alcohol use. Using alcohol with medicines can increase the risk of accidental overdose.
• Keep your prescription drugs safe. Keep track of drug quantities and keep them in a locked medicine cabinet.
• Make sure your child isn't ordering drugs online. Some websites sell counterfeit and dangerous drugs that may not require a prescription.
• Properly dispose of medicines. Don't leave unused or expired drugs around. Check the label or patient information guide for disposal instructions. You can also ask your pharmacist for advice on disposal.